Organization
JENNDA LLC
Active
Organization
JENNDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANN HAWKINS MS, SUDP (CO-OWNER)
(208) 889-8594
Entity
Organization
Contact information
Practice address
4305 N ROYAL ST, COEUR D ALENE, ID 83815-9237
(208) 889-8594
Mailing address
PO BOX 19604, SPOKANE, WA 99219-0034
(208) 889-8594
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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